Title: HRCT Lung in a Follow up Patients of Bone Marrow Transplant with Cough and their Pathological Correlation
Authors: Abhishek Dwivedi, Pankaj Pandey, Neha Kakria, B P Singh, Rachit Sharma, Vikas Verma, K P Sengar, S K Pannu
DOI: https://dx.doi.org/10.18535/jmscr/v4i11.41
Abstract
Introduction: Bone marrow transplantation is today’s procedure of choice for management of various malignancies and immunologic disorders. HRCT is the common technique in the diagnosis of such recipient’s with respiratory symptoms. This study we will target the accuracy of the modality and its pathological correlation.
Aim To study the role of HRCT in transplant patients with respiratory symptoms and their pathological correlation.
Material and Methods Patients are screened for pre transplant chemotherapy, clinical examination, lab investigations including blood and biochemical examinations, radiological examinations and a follow up for post transplant infections and complications with 16 slice Siemens CT scan.
Result Study included total 52 patients The patients presented early symptoms (<30 days) and findings were associated with prolonged neutropenia and later excluded due to non-engraftment.
Conclusion: Study claims pick up of findings on the HRCT which were not seen on routine chest radiograph and confirmed pathologically. This study suggests use of HRCT for early diagnosis.
Keywords- immunosuppression, pneumonia, algorithms.
References
1. Richard K, Burt, H. Joachim Deeg. Bone Marrow Transplantation, WH 300 B712 1998. P. 478-518.
2. Eleftheria Hatzimichael, Mark Tuthil et al. stem cell cloning advances and applications. 2010:03 105-117.
3. Tomas Franquet, Sonia Rodriguez, Rodrigo Martino, Ana Giménez ,Teresa Salinas, Alberto Hidalgo, Thin-Section CT Findings in Hematopoietic Stem Cell Transplantation Recipients with Respiratory Virus Pneumonia. AJR Oct 2006 Volume 187, number 4.
4. Santos GW, History of Bone Marrow Transplantation. Clin Haem 1983; 12;611-39.
5. Soubani AO, Miller KB, Hassoun PM. Pulmonary complications of bone marrow transplantation. Chest 1996; 109:1066–1077.
6. Gulbahce HE, Manivel JC, Jessurun J. Pulmonary cytolytic thrombi: a previously unrecognized complication of bone marrow transplantation. Am J Surg Pathol 2000;24:1147–1152.
7. Hsieh MY, Chiou TJ, Hung GY, Yen HJ. Outcomes of matched sibling and alternative donor stem cell transplantation for 26 children with severe aplastic anemia. Int J Hematol. 2010;91:54–60.
8. Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid and hematopoietic stem cell transplantation. Am J Respir CritCareMed2004;170:22–48
9. Freudenher TD, Madtes DK, Curtis JR. Cummings P, Storer BE, Hackman RC. Association between acute and chronic graft-versus-host disease and bronchiolitis obliterans organizing pneumonia in recipients of hematopoietic stem cell transplants. Blood 2003;102:3822–3828
10. Parikh Purvish M, Shah Pankaj M, Easow Jose Kumar Lalit. 50 years of HSCT in India.
11. American Thoracic Society/European Respiratory Society. (2002). International Multidisciplinary Consensus Classifica-tion of the Idiopathic Interstitial Pneum-onias. Am J Respir Crit Care Med; 165: 277–304
12. Sorror ML, Maris MB, Storb R, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106:2912–2919.
13. Korbling M, Przepiorka D, Huh YO. Allogeneic blood stem cell transplantation for refractory leukemia and lymphoma: potential advantage of blood over marrow allografts. Blood. 1995;85:1659–1665.
14. Evans A, Steward CG, Lyburn ID, Grier DJ. Imaging in haematopoietic stem cell transplantation. Clin Radiol 2003;58:201–214
15. Wah TM, Moss HA, Robertson RJH, Barnard DL. Pulmonary complications following bone marrow transplantation. Br J Radiol 2003;76:373–379.